Non-neoplastic Polyps of the Gallbladder
2019; Lippincott Williams & Wilkins; Volume: 44; Issue: 4 Linguagem: Inglês
10.1097/pas.0000000000001405
ISSN1532-0979
AutoresOrhun Çığ Taşkın, Enrique Bellolio, Nevra Dursun, İpek Erbarut Seven, Juan Carlos Roa, Juan Carlos Araya, Miguel Villaseca, Óscar Tapia, Courtney L. Vance, Burcu Saka, Serdar Balcı, Pelin Bağcı, H. Losada, Juan M. Sarmiento, Bahar Memiş, Burçin Pehlivanoğlu, Olca Baştürk, Michelle D. Reid, Jill Koshiol, Jeanette D. Cheng, Yersu Kapran, Volkan Adsay,
Tópico(s)Genetic factors in colorectal cancer
ResumoThere is no systematic histopathologic analysis of non-neoplastic polyps in the gallbladder. In this study, in addition to a computer search for cases designated as “polyp,” a systematic review of 2533 consecutive routinely sampled archival and 203 totally submitted prospective cholecystectomies were analyzed for >2 mm polyps (cut-off was based on radiologic sensitivity). A total of 447 non-neoplastic polyps were identified. The frequency was 3% in archival cases and 5% in totally submitted cases. Only 21 (5%) were ≥1 cm. The average age was 52 years, and the female to male ratio was 3.1. Two distinct categories were delineated: (1) injury-related polyps (n=273): (a) Fibro(myo)glandular polyps (n=214) were small (mean=0.4 cm), broad-based, often multiple (45%), almost always (98%) gallstone-associated, and were composed of a mixture of (myo)fibroblastic tissue/lobular glandular units with chronic cholecystitis. Dysplasia seen in 9% seemed to be secondary involvement. (b) Metaplastic pyloric glands forming polypoid collections (n=42). (c) Inflammatory-type polyps associated with acute/subacute injury (11 granulation tissue, 3 xanthogranulomatous, 3 lymphoid). (2) Cholesterol polyps (n=174) occurred in uninjured gallbladders, revealing a very thin stalk, edematous cores devoid of glands but with cholesterol-laden macrophages in 85%, and cholesterolosis in the uninvolved mucosa in 60%. Focal low-grade dysplasia was seen in 3%, always confined to the polyp, unaccompanied by carcinoma. In conclusion, non-neoplastic polyps are seen in 3% of cholecystectomies and are often small. Injury-related fibromyoglandular polyps are the most common. Cholesterol polyps have distinctive cauliflower architecture, often in a background of uninjured gallbladders with cholesterolosis and may lack the cholesterol-laden macrophages in the polyp itself. Although dysplastic changes can involve non-neoplastic polyps, they do not seem to be the cause of invasive carcinoma by themselves.
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